Agnieszka Łaba-Stefanek, Ewelina Dziwota and Marcin Olajossy
The prevalence of schizophrenia in a population is about 1%. Many efforts are constantly made to find the cause of this mental illness. Authors of this article provide groups of factors influencing the development of the disease. Among these factors, genetics seems to be an interesting and reasonable trend of exploration. GWAS research studies allow not only determining the point mutations in the genome, but also try to give an answer to the question about the biological mechanisms of disease. A microRNA MIR137, which is involved in neurogenesis and maturation of neurons may be an example. However, the genetic component may not always be sufficient to trigger symptoms. Definitely, a large group of environmental factors has an important role. Schizophrenia is a complex disease in which many genes interact with the environment. This article is a presentation of genes and the impact of various external environmental factors, leading to the onset of schizophrenia. Interrelationship between polygenic determinant of disease and the impact of both environmental and social factors in future will certainly become the field of interest for research concerning the etiology and course of schizophrenia-spectrum disorders.
Joanna Róg, Ewa Stelmach, Bożena Śpila, Jacek Gajewski, Dariusz Juchnowicz, Aleksandra Korzeniowska, Joanna Tomaka and Hanna Karakuła-Juchnowicz
Ω-3 unsaturated fatty acids are compounds belonging to the group of essential fatty acids (EFAs). The history of the discovery of EFAs dates back to the 1930s of the twentieth century, however, growing interest in ω-3 EFAs in the context of mental health has been observed since the year 2000. In view of their multidirectional action, these compounds are a promising form of adjunctive therapy of many illnesses, including psychiatric disorders. The present article aims to review the literature on the clinical applicability of ω-3 EFAs in treating schizophrenia. We present the results of preclinical studies in this area and the mechanisms of ω-3 EFAs action discussed by the authors. The randomized controlled trials (RCTs) evaluating the possibility of using ω-3 EFAs in schizophrenia are characterized in detail. The results of the tests are not clear, which may result from the methodological diversity of interventions made. Ω-3 EFAs seem to be a promising form of adjunctive therapy of schizophrenia. Further research is needed, which will allow for defining groups of patients in which intervention will bring the expected results.
Anna Urbańska, Agnieszka Lis, Mateusz Sołowiej, Aneta Perzyńska-Starkiewicz, Diana Szymczuk and Marcin Olajossy
Purpose: A case of schizophrenia with coexisting obsessive-compulsive symptoms is reported.
Case: The frequency of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) occurrence among patients suffering from schizophrenia is considerably higher in comparison to general population. The results of some studies show that schizo-obsessive disorder is characterized by higher intensity of negative and depressive symptoms. Patients with comorbid schizophrenia and obsessive-compulsive disorder show greater level of social dysfunction and they exhibit suicidal behaviours more often than patients diagnosed with schizophrenia. We present a 33-year-old female with obsessive-compulsive symptoms with onset in her early teens with no satisfactory response to treatment, in spite of her good intellect and insight into illness and cooperation.
Comment: There is some evidence suggesting that patients with “schizo-obsessive disorder” have a worse prognosis compared to the group of patients suffering only from schizophrenia, but the effect of OCD on schizophrenia symptom profile is unclear.
Ewelina Dziwota, Urszula Fałkowska, Katarzyna Adamczyk, Dorota Adamczyk, Alena Stefańska, Justyna Pawęzka and Marcin Olajossy
Rett syndrome is a neurodevelopmental genetic disorder and, because of some behavioral characteristics, individuals affected by the disease are known as silent angels. Girls with Rett syndrome perform stereotyped movements, they have learning difficulties, their reaction time is prolonged, and they seem alienated in the environment. These children require constant pediatric, neurological and orthopedic care. In the treatment of Rett syndrome physical therapy, music therapy, hydrotherapy, hippotherapy, behavioral methods, speech therapy and diet, are also used. In turn, psychological therapy of the syndrome is based on the sensory integration method, using two or more senses simultaneously. In 80% of cases, the syndrome is related to mutations of the MECP2 gene, located on chromosome X. The pathogenesis of Rett syndrome is caused by the occurrence of a non-functional MeCP2 protein, which is a transcription factor of many genes, i.e. Bdnf, mef2c, Sgk1, Uqcrc1. Abnormal expression of these genes reveals a characteristic disease phenotype. Clinical symptoms relate mainly to the nervous, respiratory, skeletal and gastrointestinal systems. Currently causal treatment is not possible. However, researchers are developing methods by which, perhaps in the near future, it will be possible to eliminate the mutations in the MECP2 gene, and this will give a chance to the patient for normal functioning.
The paper presents the etiology and pathogenesis of the disease, genetic, clinical, pharmacological aspects and other forms of Rett syndrome treatment.
Professional predispositions are an important component characterising people working as health care professionals. The aim of this study was to compare professional predispositions of students at medical courses with professionally active nurses. The study methods included a survey (SOPZ) and the Delta questionnaire. The analysis showed there were no differences in levels of sense of threat, responsibility and creativity in all analysed group, as well as while there was a differentiating influence of the sense of control in the analysed group of students.
Kamil Jonak, Paweł Krukow and Hanna Karakuła-Juchnowicz
Background: According to current knowledge, gamma frequency is closely related to the functioning of neural networks underlying the basic activity of the brain and mind. Disorders in mechanisms synchronizing brain activity observed in patients diagnosed with schizophrenia are at the roots of neurocognitive disorders and psychopathological symptoms of the disease. Synchronization mechanisms are also related to the structure and functional effectiveness of the white matter. So far, not many analysis has been conducted concerning changes in the image of high frequency in patients with comorbid schizophrenia and white matter damage. The aim of this research was to present specific features of gamma waves in subjects with different psychiatric diagnoses and condition of brain structure.
Methods: Quantitative analysis of an EEG record registered from a patient diagnosed with schizophrenia and comorbid white matter hyperintensities (SCH+WM), a patient with an identical diagnosis but without structural brain changes present in the MRI (SCH-WM) of a healthy control (HC). The range of gamma waves has been obtained by using analogue filters. In order to obtain precise analysis, gamma frequencies have been divided into three bands: 30-50Hz, 50-70Hz, 70-100Hz. Matching Pursuit algorithm has been used for signal analysis enabling assessing the changes in signal energy. Synchronization effectiveness of particular areas of the brain was measured with the aid of coherence value for selected pairs of electrodes.
Results: The electrophysiological signals recorded for the SCH+WM patient showed the highest signal energy level identified for all the analyzed bands compared to the results obtained for the same pairs of electrodes of the other subjects. Coherence results revealed hipercompensation for the SCH+WM patient and her level differed substantially compared to the results of the other subjects.
Conclusions: The coexistence of schizophrenia with white matter damage can significantly disturb parameters of neural activity with high frequencies. The paper discusses possible explanations for the obtained results.
Alena Stefańska, Ewelina Dziwota, Marcin Stefański, Alicja Nasiłowska-Barud and Marcin Olajossy
The concept of “hysteria” comes from the Greek word “hystera” (uterus) and dates back to the time of Hippocrates, at least. Modern classifications differ regarding the area encompassed by the concepts of dissociation and conversion differ. Mental health professionals in the United States (DSM-5) use a standard classification of mental disorders codifying dissociative disorders as a distinct class of disorders, but subsumes conversion disorders under “somatoform disorders”. The history of hysteria is as long as the history of mankind. Apparently, both the essence and mechanisms of dissociative disorders remain unchanged despite the fact that many years have passed. According to Owczarek et al., dissociative symptoms are caused by the malfunctioning of defence mechanisms and anxiety. This article provides an overview of the available literature on the etiology and pathogenesis of dissociative disorders as well as disorders such as amnesia, dissociative fugue, trance and possession.
Despite the increasing offer of antipsychotic drugs, the effectiveness of pharmacotherapy in schizophrenia is still unsatisfactory. Drug resistance, lack of complete remission and the increasing risk of metabolic complications are the reasons why the new forms of therapy in schizophrenia among which unsaturated essential fatty acids omega 3 (EFAs ω-3) affecting the proper functioning of nervous system, are mentioned, are being looked for.
Fatty acids represent 50-60% of the dry weight of the brain and diet is one of the factors that influence the value of each of the fat fractions in the neuron membranes. Patients with schizophrenia tend to have irregular nutritional status concerning essential fatty acids ω-3, which might result from metabolic disorders or irregular consumption of fatty acids.
Apart from being a review of the literature on this subject, this very paper characterizes essential fatty acids ω-3, their metabolism, the most important sources in the diet and the opinions of experts in the field about the recommended intake. It pays attention to the role of essential fatty acids in both the structure and functioning of the central nervous system is, as well as their role in the pathophysiology of schizophrenia, with particular emphasis on the membrane concept by David Horrobin. The assessment of the errors in consumption and metabolism of essential fatty acids are described as well.
The evidence was found both in epidemiological and modeling studies. It supports the participation of EFAs in etiopathogenesis and pathophysiology of schizophrenia. Further research is needed, both observational and interventional, as to the role of essential fatty acids ω-3 in the functioning of the CNS as well as the development and course of schizophrenia.
Ewelina Dziwota, Diana Żmuda, Rafał Dubiel, Kamila Dziwota, Renata Markiewicz, Marta Makara-Studzińska and Marcin Olajossy
This article is a case study of a 28-year-old patient diagnosed with F23. The report is preceded by an extensive literature review describing the situation of the mentally ill, in which psychiatry intermingles with spirituality and the sacrum.
The aim of the study was to investigate the relationship between religion/spirituality and schizophrenia as well as to draw attention to the complex problem of differential diagnosis of religious and spiritual problems. When is psychiatric treatment enough and when is intervention of a priest really essential?
The authors discuss the problem of mental disorders in connection with religion and spirituality in the clinical context. The article shows that it is very important that the processes of diagnosis and treatment take into account the patients’ individual traits, beliefs, values and spirituality.
Żaneta Brudkowska, Katarzyna Jusiak, Michał Próchnicki, Beata Gołębiowska, Justyna Morylowska-Topolska, Ewelina Dziwota, Paweł Pawełczak and Hanna Karakuła-Juchnowicz
The number of diagnoses of Autism Spectrum Disorders (ASD) is on the rise, which encourages the search for their causes spurs researchers to study co-occurrence of ASD with other diseases and disorders. This study aims at highlighting the importance of the clinical problem of autism spectrum disorders and its comorbidity with epilepsy. This is one of the most common co-morbidities happening to children.
Regarding the psychopathological symptoms, it needs emphasizing that both in case of an isolated ASD and epilepsy itself, the accompanying psychiatric symptoms are confirmed. The research conducted so far also shows that in the course of epilepsy in the child / youth, mental health problems are often revealed, particularly depression and anxiety disorders. Episodes of depression and anxiety disorders are also mentioned as the most common comorbid psychopathological symptoms associated with ASD. An accurate and rapid diagnosis of epilepsy can improve the functioning of the child in the family environment and can improve communication skills. It is also important for the overall intellectual and psychological development. Making a correct diagnosis of the problem is equally crucial as choosing the right methods of medical and psychological care. Moreover,, it determines the early use of adequate, safe and effective forms of treatment.